Please note that if your child(ren) are 18 years and over they will need to complete their own registration form.

Children (Name, Gender and Date of Birth)

Section Three - Whakapapa

Please note, that if insufficient detail is provided your registration there will be a delay in processing.
Please provide any extra comments or detail in the comment box of this section. If you need assistance please phone 0800-895-212

All information will be used at the discretion of Ngati Pukenga Iwi ki Tauranga Trust.

Ngati Pukenga Iwi ki Tauranga Trust will make available to you upon request the personal
information it holds about you and will make any appropriate corrections to that information
to ensure that information held is accurate.

I acknowledge that in submitting this form I declare that the information I have provided
is true and correct; and

I consent to the use of this information by the Ngati Pukenga Iwi ki Tauranga Trust and
Te Tawharau o Ngati Pukenga or any related or succeeding body in order to maintain a
tribal register for the purposes of any Act, for contact databases and any other purpose
which Ngati Pukenga Iwi ki Tauranga Trust and Te Tawharau o Ngati Pukenga or any related
body considers reasonable.

Please check the box to show your acceptance to the above points in the Privacy Statement and Declaration * Agree